After receiving my third phone call in two days from my transfusion service personnel with concerns about our inventory, I realized yet again how important the role of stewardship is to our blood supply. Inventory issues seem more glaringly apparent during inclement weather or holiday seasons, however stewardship should be a continuous and daily activity.
Most transfusion medicine texts comment generally on the role of the transfusion medicine physician or director in helping to steer component inventory and availability for surgical and medical needs.1 But there are more pieces to this process which should include physicians, nurses, laboratory professionals, administration and the blood suppliers as part of a well defined plan.
I was recently reviewing several websites and found numerous excellent examples of stewardship processes ranging from hospitals in smaller communities in the U.S. to plans for the entire Canadian Blood System.2 Several of these plans incorporate a color coded alert system with definitions of product quantity and anticipated availability over the next hours to days.
At Jewish Hospital, we have a color coded alert system in conjunction with our blood supplier that is specifically based on our case mix and complexity. If an alert is issued internally it is communicated via email and text messaging for primary areas of the hospital (e.g. cardiovascular service, transplant service, ED, main OR). The alert is placed on our physician website and a message scrolls on our plasma screens throughout the hospital. The message is updated as needed. Internally the medical staff has approved a list for triaging medical and surgical transfusions during times of shortage. This involves cooperation and coordination between attending physicians, nursing and transfusion service so that components are utilized effectively and efficiently.
Keep in mind too, that roughly one-third of this nation’s population is eligible to donate blood, yet less than 10% of the population donates annually.3 Not only should healthcare professionals be faithful stewards of our hospital inventories and make careful medical decisions for the transfusion of blood components, we should accept and spearhead the civic duty to donate blood whenever possible. This is a simple act of pure volunteerism.
The responsibility falls on each of us to steward blood product inventories not only within our own facilities but throughout the communities where we live and work. We must all be cognizant of our patients and our blood supply whether we provide bedside patient care in a clinical setting or bench-side patient care in the laboratory. Quality, safe transfusion practice is “vein-to-vein,” from donor to recipient. The next transfusion might be for YOUR parent, YOUR child, YOUR dear friend … they all deserve YOUR careful consideration.